Abstract

This article demonstrates how the concept of citizenship can be used to analyse the regulatory state, with particular reference to the safety and efficacy of pharmaceutical products in Western Europe. Empirical evidence on the citizenship dynamics of medicines regulation in Europe, which is drawn from documentary and interview data, is marshalled to interrogate theories of the decline in medical authority and `disorganized capitalism'. It is argued that late modernity has seen a pharmaceutical sector in which consumers have become more active and critically reflexive citizens, but the decline in producer power or in medical authority by the fracturing of expertise (or otherwise) has been minimal. It is concluded that the balance of evidence shows that the sector is highly organized, producer-driven, oligopolous and standardized, rather than disorganized, fragmented and flexible, despite consumers' growing activism and reflexivity.

Item Type:

Article

Additional Information:

Based on ESRC-funded international empirical research in various European countries (ESRC Ref L323253012), the article uses a citizenship-based analytical framework to highlight limitations of sociological theory of `disorganised capitalism' and of declining medical authority in medical sociology by examining the pharmaceutical sector within European capitalism. It is innovative in expanding citizenship analysis beyond `welfare' to `rights to security in health', and was taken up by the World Health Organisation (2005, 2006) in their `Health Security' report and cited by the European Commission's MEDUSE research programme `Health Security Agencies'. Lewis collected data, both authors undertook literature reviews, analysed data; Abraham wrote the paper.